gms | German Medical Science

Background and status of (inter)national research: During the coronavirus crisis, German nursing homes became hotspots of the pandemic, associated with significant mortality rates and protective measures, which might have detrimental effects on the medical healthcare supply.

Question and objective: The aim of the study is to evaluate the medical healthcare of the nursing home residents during the pandemic from the point of view of the nursing managers. This includes to investigate the presentation and development of access rules of external health care providers.

Method or hypothesis: This study is part of COVID-Heim, a cooperation project that combines various data sources in order to draw lessons from the corona pandemic for structural developments in nursing homes. The online survey of nursing home managers was designed to provide information about medical care during the first lockdown (March 01–June 30, 2020). Recruitment was conducted via e-mail and mail. The questionnaire was provided online via a survey platform named REDCap and was available from November 11, 2020–February 28, 2021.

Results: Data from N=1010 nursing managers constitute the final dataset. Initial descriptive evaluations indicate that access restrictions were in place for almost every third physician visit in different specialist areas (e.g. access with restrictions at every third primary care visit 33.1%). In some cases, access is even completely restricted. One-fourth physical therapists and occupational therapists no longer had access to nursing homes at all (26.1% and 25.5%). In the case of access with restrictions, it is even every second. One-third (33.5%) of nursing managers with COVID-19 cases among residents (N=167 nursing homes) at their nursing homes reported specialist care deficits. In the context of the distribution of COVID-19 cases among residents or nursing staff (N=261), 31% of the home directors also indicate a deficient specialist care situation.

Discussion: Initial descriptive data show ambulatory medical healthcare deficits. Measures for effective and safe ambulatory medical care during the pandemic should be discussed urgently. Future analyses of secondary data (routine data) and further evaluations regarding COVID-19 protective measures in conjunction with the statements of nursing home directors may complete the picture of care in order to improve future healthcare during crises.

Practical implications: Conclusions for appropriate measures of future care in nursing homes will be derived. Preventive action recommendations of infection risks in nursing homes that allow conteneous access of medical professionals are needed. Far-reaching consequences on the general health of the residents in long-term should be highlighted.

Appeal for practice (science and/or care) in one sentence: The task is to find the key factors for the locked doors of the healthcare system and turn them around correctly – COVID-19 has once again shown us the deficits; let us tackle them.